Kenya: Urgent Action Needed to Avert Resistant TB - Activists

UN Integrated Regional Information Networks

December 13, 2006
Posted to the web December 13, 2006

Nairobi

Kenya risks falling victim to new, drug-resistant strains of tuberculosis (TB), found elsewhere on the continent, if the government fails to take the TB epidemic more seriously, activists have warned.

"Multidrug-resistant (MDR) and extremely drug-resistant (XDR) TB are a direct consequence of non-adherence to treatment regimens," Dr Ignatius Kibe, a contagious disease expert and member of the Kenya AIDS NGO Coalition (KANCO), told PlusNews. "More resources must be pumped into prevention of non-adherence."

XDR-TB has been detected in South Africa, where it has led to the death of more than 70 people in the east-coast province of KwaZulu-Natal. So far, no cases of XDR have been detected in Kenya.

MDR-TB develops when a TB strain becomes resistant to two or more first-line antibiotic drugs, and becomes XDR-TB when it is resistant to two or more second-line antibiotics. According to Kibe, an estimated 60 percent of Kenyans with TB are also co-infected with HIV. Although TB is preventable and curable, it is the leading cause of death in HIV-infected people, he added.

At a recent KANCO press conference, Mutinda Kithuku, a secondary school teacher living with both TB and HIV, urged the government to provide drug regimens that were easier to adhere to. "TB and ARV [antiretroviral] drugs are not a pleasant experience - I have to take two [tablets] per day for TB, two ARVs [antiretrovirals] per day, two antibiotics per day and a vitamin tablet," he said. "This is a total of seven - when you are sick, it is difficult to remember them all."

More effort needed to roll back TB

KANCO noted in a memorandum, handed to the government earlier this month, that while there had been some success in reducing the spread of HIV/AIDS, the time had come for the authorities to pay more attention to TB.

Dr Despaul Muthama, of the National TB Control Programme at the Ministry of Health, said 108,000 Kenyans were diagnosed with TB in 2005, and the health ministry had treated about 85 percent of those, but he believed this was just 50 percent of the actual number of infections.

Kibe said TB was a particular threat to residents of Nairobi's Kibera and Mathare slums - two of the largest and most densely populated informal settlements in Africa - which had a combined population of over two million people.

According to recent research by the International Journal of Tuberculosis and Lung Disease, about 70 percent of Kenya's urban population lived in 70 slums across the country. "With the poor living and housing conditions, like overcrowding, poor sanitation, lack of water and high illiteracy, a very high proportion of this population is either infected or affected by HIV and TB."

The government intended increasing the number of people diagnosed to 70 percent in 2007. "When we test people for TB, in order to ensure that they receive the maximum benefit from the services, we also test for HIV," Muthama said.

Kenya is ranked 10th on the United Nations World Health Organisation's list of 22 countries that bear 80 percent of the world's TB burden.